I have written about this many times in the past, but I’ve been corresponding with someone over e-mail that said something to me that was upsetting. Here is the blurb from the e-mail that got to me…..

“Immediately after the stroke, I basically said to anyone exactly what I thought, I was far from polite. I would call that my Filter, it was my lack of holding back an inappropriate comment. I became more filtered as time went, sort of like how a child becomes more filtered with age, so I am fairly filtered right now with my comments. I am honest but not offensive. I explain this because many arguments are moments when it doesn’t do any good to be unfiltered. Honesty is one thing, but sometimes it is most productive in an argument to respond, or not respond, a certain way.”


This lack of filter is a neurological condition that everyone I’ve ever met with a brain injury has experienced. It’s called Pseudobulbar Affect. Look it up.  When I was lying in a hospital bed 85% dead, I was told that I was being mean to some visitors.  The months following my stroke when I was about 60% dead, I was frequently told that I was saying inappropriate things, and that I needed to change the way that I interact with people.  A few years after the stroke when I had improved to about 45% deadness, some of the things that I said during that time were brought up to me as examples of how mean I was and why some people didn’t want to come see me.   I was told these things by the people closest to me that were supposed to love and support me the most.  I was told these things were a problem with ME and not a result of the absolutely horrible, devastating medical condition that had just taken over my entire life.


This meanness, this “lack of filter,” this honesty, this saying horrible, racist things like I did, this inappropriate laughing or crying is a neurological condition that CANNOT BE CONTROLLED.  It’s the weirdest thing in the world and utterly impossible for someone who has never had a brain injury to understand.  Just impossible.  To try to explain to someone that you actually can’t control the words that come out of your mouth is completely incomprehensible to most people, I understand that.  What I don’t understand is that no one in my life at the time took a few minutes to read a GD article or two in order to try to understand why I was acting like this.  How selfish of me to think that at the absolute lowest, darkest, and most vulnerable point of my life that anyone around me would try to increase their knowledge and learn how to better deal with my behavior that I COULD NOT CONTROL.


If you’ve stumbled onto this blog, it’s probably because you yourself or someone you know and love had a stroke.  Please read about PBA and – you won’t understand it, but you can educate yourself about it.  The last two abstracts I have linked mentions that damage to the cerebellum in and of itself can cause de-regulation of emotions, so I have both issues, lucky me!!







Categories: Brain stuff, Health, Recovery, Stroke stuff

Tags: , , , , ,

10 replies

  1. Thank you for this post. I suffered from a similar problem and depression, after getting dystonia secondary to stroke. This explains a lot.

    Thank you, thank you, thank you! 🙂

  2. Your doctor and therapists should have had information to give to your visitors about PBA, they are supposed to know about it and the effects it can have on relationships. Anyway, that’s who I blame. But what do I know? I’m stroke-addled, lost 5 years of my cognitive age.

  3. As PBA was explained to me by my therapists/docs, it was simply a matter of not controlling emotions, not words. It explained me laughing as my world fell apart and crying when I was happy, not my observation that an acquaintance was “stout.”

    How about someone out there (Amy?) writes a one-page info sheet about PBA and we can get our on-the-ball stroke associations to distribute it? Like part of an “awareness” campaign.

    • Well, that’s not an accurate description if they only explained the emotionality part of it to you. It’s very much words too, things you say. Very much so. That’s the “lack of filter.” That part of it doesn’t affect everyone but it most certainly affected me in that way. People should take my description of it – a medical professional who has experienced this severely and intensely, rather than someone who went to school and learned about it. You’re right I should hound the stroke associations about the description and explanations of this. It kills relationships.

  4. I don’t think I had/have PBA…. But I did give some of the idiots that were in my life the boot…not because I was injured but because I finally figured out they were idiots and my time here is limited. I’m not wasting my time with idiots so out they went…they all claimed my “stroke” made me change….I finally got rid of them…thank god!! Yes, I was/am different, but I think I was very in control of what came out of my mouth, even the nasty things….lol… They would have loved to believe it was PBA and not the truth because the truth means they were just crappy people, which was the case.

  5. PBA…PBA….PBA OMG!!! I totally and completely understand.<—– massive bilateral cerebellar stroke 6-2015. I went to see my former co worker and my daughter asked what she looked like and I said "She's the really fat one you can't miss her." 😑😡 Not to mention 30 minute intervals of laughing/crying attacks. No one who has not experienced TBI like stroke will ever understand. But that doesn't cover others inability to have empathy. I could go on and on. Love your blog.


  1. Savant – mycerebellarstrokerecovery

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